实用肿瘤学杂志 ›› 2009, Vol. 23 ›› Issue (1): 22-25.

• 论著 • 上一篇    下一篇

肾盂移行上皮细胞癌CT诊断

张淑平1, 郑文龙2, 邱乾德1, 相世峰1, 黄晓辉1   

  1. 1.浙江省温州市第三人民医院影像科(温州 325000);
    2.浙江省温州市第二人民医院放射科
  • 收稿日期:2008-11-10 出版日期:2009-01-20 发布日期:2012-02-21
  • 作者简介:张淑平, 女, (1967-), 副主任医师, 从事影像诊断工作

Diagnosis of CT in renal pelvis transitional cell carcinoma

ZHANG Shuping, ZHENG Wenlong, QIU Qiande, XIANG Shifeng, HUANG Xiaohui   

  1. Department of Radiology, Wenzhou Third People′s Hospital of Zhejiang, Wenzhou 32500
  • Received:2008-11-10 Online:2009-01-20 Published:2012-02-21

摘要: 目的探讨肾盂移行上皮细胞癌CT特点, 评价CT在肾盂移行上皮细胞癌诊断中的价值。方法 报告经手术病理证实的肾盂移行上皮细胞癌32例, 回顾性分析CT表现。结果 32例中15例见肾盂、肾盏内1.5cm-4.0cm大的结节状软组织肿块影, 肾窦脂肪受压、变薄, 但间隙存在;8例见肾盂、肾盏内直径4.1cm-9.0cm肿块, 累及肾门, 肾窦脂肪间隙消失;4例沿肾盂壁浸润性生长, 肾盂壁不规则增厚, 经肾门蔓延至输尿管上端, 肾盂、肾盏轻度扩张积水;5例肿块浸润肾实质, 并侵犯邻近组织, 形成密度不均的团块, 分不清肾盂、肾盏和肾实质, 肾门和腹膜后淋巴结增大。平扫:32例CT值33Hu-50Hu, 其中25例等密度, 4例略高密度, 3例略低密度;密度均匀21例, 密度不均匀11例;瘤内伴有小斑片状高密度出血灶5例, 小点状钙化5例, 坏死囊变3例。增强:CT增强扫描21例中13例于皮质期见肿块呈轻度均匀强化, 轻度不均匀强化8例;21例于实质期及肾盂期病灶强化程度均无明显增加, 与邻近增强肾实质相比, 肿瘤略呈低密度。32例中CT直接诊断肾盂癌21例, 提示肾盂癌可能7例, 误诊2例, 漏诊2例。结论 肾盂移行上皮细胞癌在CT平扫以等密度, 增强以轻度强化为主要征象, 在病灶的发现及定性, 螺旋CT具有较高价值。

关键词: 肾盂, 移行细胞癌, X线计算机

Abstract: Objective To study the feature of CT in renal pelvis transitional cell carcinoma and evaluate the diagnosis value in transitional cell carcinoma of renal pelvis with CT.Methods A report of 32 cases with transitional cell carcinoma of renal pelvis proved by surgery and pathology.The examinations were performed with CT scan before the operation, finally, a sensitivity analysis was performed.Results In the 32 cases:15 cases, soft tissue was observed, the diameters were 1.5-4.0cm, in renal pelvis and calyx, the displacement or amputation of renal sinus fat line and thinning, with the clearance;8 cases, soft tissue was observed, the diameters were 4.1-9.0cm, in renal pelvis and calyx, involved the renal hilum, the disappearance of the renal sinus fat clearance;in 4 cases, invasive growing along the renal pelvis wall, abnormal thickening of the renal pelvis walls, from the renal hilum to upper end of ureter, the mild dilated and hydrops in the renal pelvis and calyx;in 5 cases, invasion of the renal essence and adjacent tissues, inhomogeneous tumor in density were formed, it was difficult to distinguish the renal pelvis, renal calyx and renal essene, the lymph node increased in renal hilum and retroperitonal.In the 32 cases:CT plain scan, CT Value33-50Hu, 25 cases isodense, 4 cases lightly high density, 3 cases slightly low density;21 cases even density, 11cases uneven density, 5cases hemorrhagic focus of tumor, 5 cases calcification of tumor, 3cases necrosis and cystic lesions of tumor.21 cases CT enhanced scan could reveal the light to moderate enhancement of the tumor, 13 cases were enhanced even slightly, 8 cases were enhanced uneven slightly of the tumor on cortex stage;there was no significant change in the parenchymal phase and renal pelvis phase compared with cortex stage in the contrast-enhanced.In the 32 cases:the 21 cases were determined and the 7 cases were suspected, the 2 cases were misdiagnosed and the 2 cases were normal.Conclusion the main sign was isodense in plain scan and enhanced scan of CT for transitional cells carcinoma of renal pelvis, CT has heigher diagnostic sensitivity and accuracy on finding and qualitation.

Key words: Renal pelvis, Transition cell carcinoma, X-ray computed

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